179015 05/13/2009 L
CITY OF CARMEL, INDIANA VENDOR: Page 1 of 1
ONE CIVIC SQUARE 1�G�
CHECK AMOUNT:
CARMEL, INDIANA 46032
CHECK NUMBER: 179015
CHECK DATE:
r
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
l;�o -7 g s ass
IMERICA INVOICE
11 BROOKSHIRE FIRST MORTGAGE
INC, dba BROOKSHIRE GOLF CLUB
12120 BROOKSHIRE PARKWAY
2755 Commerce Dr. CARMEL IN 46032
P.O. Box 2856
Kokomo, 46904 -2856
765- 459 -311 17 RR2903542 EXP. 07 13 10
800- 382 -0675 Thursday Delivery
Fax: 765 457 -7967
BEER W3409212
INVOICE DATE INVOICE NUMBER SALESMAN NUMBER CUSTOMER NUMBER ROUTE
11/05/09 399408 Dustin Smith 13 800 13
PRODIJbT
BASE November 2, 2009A
PROMO #1109A
PUMP $40/$33 REFUNDABLE
225 1 Bud Lt 1/4 BBL 42.50 30.00 72.50
7, -50
9, 9s"
1/4 Barrels 1
OTY DESCRIPTION PRICE PROD. c TOTAL SALE
72.50
10303 EMPTY AB 1/6 30.00 T
10304 EMPTY AB 1/2 30.00 H
10405 EMPTY AB 1/4 30.00
10310 EMPTY IMPORT 1/2 30.00
9230 PUMP DEPOSIT 33.00 K
9270 IMPORT PUMP DEPOSIT 33.00 72.50
f O CREDITS
Cash EFT Escrow C l Check Number
Driver— Received B Y
d r
MIWAMERICA INVOICE
B BROOKSHIRE FIRST MORTGAGE
dba BROOKSHIRE GOLF CLUB
'NC■ 12120 BROOKSHIRE PARKWAY
2755 Commerce Dr. CARMEL IN 46032
P.O. Box 2856
Kokomo, IN 46904 -2856
a 765- 459 -3117
800 382 -0675
Fax: 765- 457 -7967 p u m t bbl/has 2 c r d t
BEER W3409212
INVOICE DATE INVOICE NUMBER SALESMAN NUMBER
I
CUSTOMER NUMBER ROUTE
10/29/09 398736 Dustin Smith 13 800 1.3
DEPOSIT AMOUNT,
'PRODUCT DESCRIPTION PRICE.
C QUANTITY,
BASE SEPTEMBER 28,2009A
PROMO #1009A
PUMP $40/$33 REFUNDABLE
760 1 Goose Wheat 312 1/6 BBL 55.00 30.00 85.00
I 1e z
1/4 Barrels 1
TOTAL SALE 85.00
10303 EMPTY AB 1/6 30.00 3 T
10304 EMPTY AB 1/2 30.00 H
10405 EMPTY AB 1/4 30.00 A
10310 EMPTY IMPORT 1/2 30.00 N
9230 PUMP DEPOSIT 33.00
9270 IMPORT PUMP DEPOSIT 33.00 85.00
CREDITS �V,
Cash EFT Escrow Check Number U
Driver i /?�i:�Y" Received By
N11WAMERICA r INVOICE
BIMIMIGE BROOKSH.I.RE F.I,RST; MQRTGAGC`
dba BROOKSHIRE GOLF CLUB
-INC, 12120 BROOKSHIRE PARKWAY
2755 Commerce Dr. CARMEL IN 46032
P.O. Box 2856
Kokomo, IN 46904 -2856
765- 459 -3117 RR2903542 EXP. 07/13/10
800 382 -0675
Fax: 765 457 -7967
BEER W3409212
INVOICE DATE INVOICE NUMBER SALESMAN NUMBER CUSTOMER NUMBER ROUTE
i
10/23/09 39B402 Dustin Smith 13 Boo 13
PRICE DE l PdSIT AMOUNT"..
QUANTITY. DESCRIPTION
BASE SEPTEMBER 28,2009A
PROMO #1009A
PUMP $40/$33 REFUNDABLE.
109 -1 Budweiser 24 Lse Can 15.95 -15.95
Cases -1
PRICE
TOTAL SALE -15.95
10303 EMPTY'AB 1/,6 30.00 T
10304 EMPTY AB 112 30.00 H
10405 EMPTY AB 1/4 30.00 A
10310 EMPTY IMPORT. 1/2 30.00' N
9230 PUMP DEPOSIT 33.00 K
9270 IMPORT PUMP DEPOSIT 33.00 —15.95
CREDITS
Cash EFT Escrow Check Number U A,
Received By.
i
WWAMERICA INVOICE
B BROOKSHIRE FIRST MORTGAGE
d ba BROOKSHIRE GOLF CLUB
NC■ 12120 BROOKSHIRE PARKWAY
2755 Commerce Dr. CARMEL IN 46032
P.O. Box 2856
Kokomo, IN 46904 -2856 HHZ CUS J 1
765- 459 -3117
800 382 -0675
Fax: 765 457 -7967
BEER W3409212
INVOICE DATE INVOICE NUMBER SALESMAN NUMBER CUSTOMER NUMBER ROUTE.
10/15/09 397518' Dustin Smith 13 800 13
BASE SEPTEMBER 28,2009A
PROMO ##1009A
PUMP $40/$33 REFUNDABLE
225 1 Bud Lt 1/4 BBL 42.50 30.00 72.50
,1
6
C
6 prr
1/4 Barrels 1
TOTAL SALE 72.50
10303 EMPTY AB 1/6 30.00 T
10304 EMPTY AB 1/2 30.00 H
10405 EMPTY AB 1/4 30.00 A
10310 EMPTY. IMPORT 1/2 30.00 N
9230 PUMP DEPOSIT 33.00 K
9270 IMPORT PUMP DEPOSIT 33.00 72.50
CREDITS �;A,AV
Cash EFT Escrow Check Number
Driver /.��e� Received B (3�
MIWA 1ERiCA INVOICE
R BROOKSH FIRST MORTGAGE
d ba BROOKSH I FEE GOLF CLj6
INC. 12120 BROOKSHIRE PARKWAY
2755 Commerce Dr. CARMEL IN 4.6032
P.O. Box 2856
Kokomo, IN 46904 -2856 i tl11yUS t X F' U 1 S/ 1
765- 459 -3117
800 382 -0675
Fax: 765 457 -7967
BEER W3409212
INVOICE DATE INVOICE NUMBER SALESMAN NUMBER CUSTOMER NUMBER ROUTE
10/07/09 396948 Dustin Smith 13 800 13
-C OD E PRobb& PRICE
OUANTIfY DESCRIPTION
BASE SEPTEMBER 28
PROMO #1009A
PUMP X40 /$33.REFUNDABLE
225 —1 Bud Lt 1/ -4 BBL 41.50 30.00 —71.50
10405 —1 AB Empty 1/4 30.00 30.00 —30.00
1/4 Barrels —1
TOTAL SALE -101.50
10303 EMPTY AB 1/6 30.00 T
10304 EMPTY AB 1/2 30.00 H
10405 EMPTY AB 1/4 30.00 A
10310 EMPTY IMPORT 1/2 30.00 N
.9230 PUMP DEPOSIT 33.00 K
9270 IMPORT PUMP DEPOSIT 33.00 —101. 50
RETURNS TOTAL CREDITS 100-
CREDITS
Cash EFT Escrow Check Number
Driver Received By �1
P?esrybsd by State Board of Accounts City Form No. 201 (Rev. 1995)
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
An invoice or bill to be properly itemized must show: kind of service, where performed, dates service rendered, by
whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc.
Payee
Purchase Order No.
0 Terms
29� Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
1017/0
o 3 ?7 S e
A)
/0 9 09 cb
i o 9 S6
Total
1 hereby certify that the attached invoice(s), or bill(s), is (are) true and correct and I have audited same in accordance
with IC 5- 11- 10 -1.6.
20
Clerk- Treasurer
VQAUCHER NO. WARRANT NO.
ALLOWED 20
'����P,� IN SUM OF
7
ON ACCOUNT OF APPROPRIATION FOR
v
Board Members
Po# or INVOICE NO. ACCT #!TITLE AMOUNT
DEPT. I hereby certify that the attached invoice(s), or
/o? 7 3 bill(s) is (are) true and correct and that the
7 9 S"/ QD �/e- 5 materials or services itemized thereon for
1,70 D� 3 0 /S, S which charge is made were ordered and
399 390 ,w received except
d 20 q
F I i �Sig�atul�re/
19�/y� Titlle'd"'
Cost distribution ledger classification if
claim paid motor vehicle highway fund